Maternity and Mortality in the 1800’s, Plus a Preview From My WIP

It’s no secret that labor and childbirth were a perilous business for women in the 19th century. Accurate records of death during childbirth do not exist for this time period * but a common estimate is 20%. Think about that for a moment: if you were a healthy young woman in 1810 or so, you had a one in five chance of dying during or shortly after childbirth. It is no surprise that Jane Austen herself lost four sisters-in-law to childbirth, or that it may have made her reluctant to enter the marriage state for herself.

It is not always so obvious what, exactly, was the cause of death in these cases, but we do know the most common complications. Childbed fever was commonly cited as a reason for a woman’s death. It was a catch-all term that included any kind of infection that made it into the bloodstream. With antibiotics still unknown, a bacterial infection often proved fatal. Other causes of maternal death were hemorrhages (from placenta previa, placenta abrupta, etc) and from what we now know as pre-eclampsia. These complications and other life-threatening conditions knew no boundaries: poor women were just as likely to survive childbirth as wealthy women, and nobody was truly safe.

I did a lot of research on this topic because of the book I am now finishing up, titled An Unexpected Turn of Events. In this story the dangers of childbirth come right to the doors of Pemberley. Elizabeth Darcy delivers a daughter named Grace, her fourth child, and seems to do well for a time. Then she exhibits the classic signs of childbed fever. Darcy is at her side, along with Mr. Bennet (Thomas) while she fights for her life. The physician who has attended Elizabeth tells Darcy and Thomas to expect her battle to be won or lost that night.

Elizabeth was agitated, and for the first time Thomas heard her struggling to breathe, drawing quick rasping breaths that did not seem to satisfy. New splotches of color were on her face and arms, and when he took her hand he felt her pulse race alarmingly.

“Shall we call the doctor again?” he asked, but Darcy shook his head, his face a mask of pain.

“He said there is nothing more he can do. All we can do now is wait.”

Thomas took a chair on the opposite side of the bed from Darcy and the long vigil began. Neither man slept as Elizabeth struggled valiantly against her illness. She was mostly unconscious as the night progressed, but that did not prevent her from calling out from time to time, incoherent snatches of sound that served no purpose but to reflect the delirium in her mind. They could not even offer her relief by sponging her face or forehead, for both had grown cool to the touch. Despite the warmth in the room, she shivered from time to time.

“At least the fever has broken,” Thomas offered after a long while, looking for any hopeful sign.

Darcy nodded tiredly. “Yes. The doctor said that might happen.” From the tone of his voice, Thomas could not tell if it was a good thing or not.

Except for Elizabeth’s labored breathing and an occasional hiss from the fire, the room was silent, but Thomas did not think he would fall asleep at such a time. It came as a surprise, therefore, when the clock over the mantle struck one and Thomas bolted awake. He must have accidentally drifted off for a short time.

He saw that Darcy had gone down on his knees next to his wife’s bed, his forehead against the mattress next to her shoulder; Thomas could not see his face. Then he heard the sound he had been most dreading: Elizabeth’s breath was catching in her throat, rattling alarmingly.

This was it, he thought despairingly. There was nothing he could do. Elizabeth had lost the fight, as so many other women in her position had done before her. At any moment she would draw her last breath and leave this world forever. Darcy would be alone, and their children would grow up without a mother.

Grace, he thought in a panicked rush. Elizabeth had barely had a chance to hold Grace.

Without a word he rose and rushed from the sick room, straight into the nursery. Mrs. Reynolds started when he came into the room. He lifted the baby from the cradle and turned back to the sick room, not stopping for explanations. Darcy did not look up when Thomas approached the other side of the bed from him until Thomas said, “Help me lift her up. She ought to have a chance to hold her daughter one last time.”

Darcy nodded silently in agreement. His eyes glistened with tears as he slipped one arm behind his wife and sat on the edge of the bed next to her. Thomas took her other shoulder and together they lifted Elizabeth to a reclining position, propped up on her husband’s chest. Thomas carefully placed the infant so that she was against her mother and cradled in Darcy’s other arm.

“Elizabeth. My dearest, loveliest Elizabeth.” Darcy spoke for the first time in many hours, his tender voice barely above a whisper. “I have loved you for the best years of my life. Forgive me where I failed you. I tried to be a better man for your sake.”

Thomas looked down on the scene, tears burning his own eyes. He was an intruder, trespassing on sacred ground. But he could not turn away.

“Do not fret about our children. They will be fine men and women when they are grown, thanks to you. I will make certain they always remember you. You will be with us in our hearts every day. Nothing can separate us. Every hour, every second that goes by, you will still be a part of us, and one day we will be together again.” Darcy stopped to press a kiss on her forehead, tears now clearly visible on his face.

“Dearest Elizabeth! It wrenches my soul to give you up! Thank you, my love, for coming into my life. Thank you for the joy you have given me, and the lessons you taught me. Thank you for letting me love you.”

He paused. Elizabeth had not stirred but something about her had changed.

“Do you hear that?” Thomas asked in a hushed voice after a moment. “Has her breathing stopped?”

In the quiet Darcy listened closely, placing his ear against his wife’s chest. “That might have been her last breath,” he said, his voice breaking.

“No, I see her chest moving!”

“You are right,” Darcy said after a moment, his voice tremulous. “She is still breathing. In fact, I think she is breathing easier than before.”

It was true. In her raised position Elizabeth’s breath no longer rattled in her throat; she had stopped gasping and was instead taking in long draughts of air. She coughed once, then coughed again.

“Dear God, can it be true?” Thomas said in wonder.

“Is this the turn the doctor spoke of?” Darcy asked, speaking almost to himself. “Her hands are warm.”

“And her color is improving!” Thomas exclaimed.

“Take another breath, love,” Darcy begged. “That is it, draw it in deeply.”

“Yes, Lizzy, fill your lungs,” her father urged. “Keep breathing. Do not give up now!”

Don’t worry, there is a happy ending for our favorite couple! But you will have to read the story to find out how it comes about, and the critical role Thomas Bennet plays in saving his daughter’s life. Look for An Unexpected Turn of Events to be released in early summer!

That is some powerful writing there, Elaine. I had followed the story on FFN, and I remember first reading the scene. So emotional and heart-wrenching! No less so this time around. I love it when JAFF writers bring me to tears! 🙂

Found your comment on Semmelweis interesting. I first learned about him in my microbiology class in nursing school. My teacher told his story with great aplomb. I actually think Semmelweis’ story would make a great movie!

Thank you Missjamieann! I love hearing when people react strongly to a particular scene. And yes, Semmelweis’ story would make a great, if tragic, story. I like reading about him and also about Lister, who followed up on Semmelweis’ ideas and developed the liquid we now know as Listerine.

I was researching childbirth and came across an article that discussed the simple act of hand washing and how that alone helped decrease mortality rates among women and children. One article mentioned doctors training on cadavers would then be called to a birthing… some wouldn’t/didn’t see the need to wash their hands… where others did. Those that did not wash their hands had a higher mortality rate than those who did wash their hands. Many still refused to see the correlation between the two.

And to make it worse, the man who tried to promote handwashing, Simmelweis, later died of sepsis. Oh, the irony. Nobody ever took his ideas seriously in his lifetime, but we all owe him an immeasurable debt.

I’m working on a story (which will probably not be published for at least 6 months) where Anne de Bourgh does not want to marry because she fears childbirth. I’m actually surprised that more women of the time didn’t think that way. Twenty percent of women dying in childbirth is huge, especially since infant mortality was also high. In order to keep the population constant, women had to have many pregnancies.

I’ve always assumed that Darcy’s mother had either miscarriages or infant deaths between her two living children.

Oh heavens, I was in tears reading that! Such a great idea of Mr Bennet and such glorious words from Darcy!
How close was that? We don’t realise how lucky we are today with modern medicine. My twin grandsons were born 10 weeks early and spent a couple of months in intensive care. Thankfully they are now 18 months old and healthy but it would have been a different story back then.
I am really looking forward to this book, thank you for sharing this excerpt.

My younger brother was born a month premature and could easily have died. It seems funny to think that now, a month premature is not considered much of a problem at all. I hope you enjoy the finished story!

This is a wonderfully poignant scene made all the more so because of our familiarity with the characters. Thank goodness for Ignaz Semmelweis. I attended the birth of all three of my children (C-section by necessity), and I cannot imagine our incredible Gyne-OBs walking in smoking a cigar and wiping their hands on their smocks before operating on my wife! Great post.

That is quite a compliment, Don. Thank you! As for Simmelweis, his story has long been fascinating to me. I may do a future post on medical advances made during Elizabeth Bennet’s lifetime, and his contribution would certainly be included in that.

I have avoided childbirth in most of my stories because it is so personal and, even writing androgynously, nearly impossible for a man to consider. I even had Mary being wed a man who would not endanger her because he was sterile in his own future (Honestly…that is why I composed that Rule of the Wardrobe)!

That would be Rule #7 as composed by Grinling Gibbons…”No male Bennet will be able to sire offspring in the future having traveled to that future through the Wardrobe in order to prevent improper relations. No female Bennet can increase in the future and then return to the past while awaiting confinement. Bennet children born in the future will not be able to return to the past with their parent.”

Mary Bennet recognized the implications of this when she addressed her betrothed (and half-uncle) Edward (Bennet) Benton (OK…that the other reason for the rule) in “The Keeper” by saying…“I will never lament not increasing with your child inside of me. If anything, I will rejoice in the knowledge that we may share our marriage bed without fear of early loss until the day our Father calls one of us home at our appointed time.” (Ch. XXXV). Yes, Edward is Thomas Bennet’s half (and elder) brother. He, however, did not wish to become Master of Longbourn and availed himself of the Wardrobe on his 21st Birthday. The cabinet translated him from 1770 to 1811 on the day of the double weddings (when Mary would have been 19). Recall that the Wardrobe sent him to where he could learn that which he needed…and become the man of God he desired to be. The Wardrobe also recognized that he and Mary were formed for each other.

LOL! You are exactly right, Don! I cried like a little baby and had to stop writing several times to compose myself. My family thought I was nuts! Regina, I’m sorry to have you in tears at such an early hour, but I promise: it does end happily! 🙂

I am following this amazing story and this excerpt had me in tears now and when I first read it! I am thankful that we live in an Era of better women’s health, especially during the reproductive years.

Meta

Blog Stats

Copyright

Austen Authors is hosted, funded, and managed by Sharon Lathan, Novelist. Co-Administrator is Regina Jeffers, Novelist. General content of the Austen Authors blog is owned by the administrators; blog posts, original writings, and novel excerpts are owned by and copyrighted to the individual author and, if applicable, the author's publishing company. Written permission from the Austen Authors administrators or the individual author must be obtained in order to legally copy and reproduce any content from this website.

All images, references, quotes, links, etc. are copyrighted to their respective owners and provided here only for enhancement of our blog posts. No copyright infringement is intended. To contact administrators for copyright queries, email at: admins@austenauthors.com Thank you.